Keywords
mistakes
complications
How to Cite
Abstract
Background. In recent decades, the number of reverse shoulder arthroplasties has increased significantly, and the number and diversification of complications has also increased.
Objective. This study aims to analyze the structure and nature of mistakes and complications that occur during reverse shoulder arthroplasty.
Materials and Methods. We observed 21 patients (20 males and 1 female) aged 36 to 81 years (mean age 54.61 ± 11.89 years) who underwent reverse shoulder arthroplasty. Among them, 16 cases of complications and 5 mistakes were identified.
Results. In 2 patients, strategic mistakes led to the development of complications. The complications were diverse. The most common was prosthesis dislocation (5 cases, 23.8% of the total number of complications and mistakes). Purulent-necrotic complications were observed in 4 patients (19%), aseptic instability of the prosthesis components occurred in 3 patients (14.3%), acromion stress fractures due to overload were noted in 2 patients (9.5%), and secondary adhesive capsulitis with severe adduction and internal rotation contractures was observed in 2 patients (9.5%).
Conclusions. The most common complications following reverse shoulder arthroplasty were prosthesis dislocation and purulent-necrotic complications. The main causes of dislocation were uncompensated shortening of the humerus and significant medialization and, in some cases, inclination of the prosthesis head. A strategic mistake in reverse shoulder arthroplasty is performing the procedure in patients with total traumatic injury to the deltoid muscle or irreparable damage to the axillary nerve (n. axillaris). An important tactical mistake is neglecting, when possible, the complete restoration of the rotator cuff, which significantly reduces flexion and rotational movements in the shoulder joint.
References
Страфун С.С., Лисак А.С., Сухін О.Ю. Невідновні розриви ротаторної манжети плеча. Вибір оптимального хірургічного лікування. Вісник ортопедії, травматології та протезування. 2019;4:10-17. DOI: 10.37647/0132-2486-2019-103-4-10-16.
Strafun SS, Lysak AS, Sukhin OY. Irreparable tears of the rotator cuff of the shoulder. Choosing the optimal surgical treatment. Visnyk Orthop Traum Protez. 2019;4:10-17 [in Ukrainian]. DOI: 10.37647/0132-2486-2019-103-4-10-16.
Keener JD, Chalmers PN, Yamaguchi K. The humeral implant in shoulder arthroplasty. J Am Acad Orthop Surg. 2017;25(6):427– 38. DOI: 10.5435/JAAOS-D-15-00682
Reuther F.; Petermann M.; Stangl R. Reverse Shoulder Arthroplasty in Acute Fractures of the Proximal Humerus: Does Tuberosity Healing Improve Clinical Outcomes? Journal of Orthopaedic Trauma. 2019;33(2):46-51. DOI: 10.1097/BOT.0000000000001338
Santana F, Alentorn-Geli E, Guirro P, Torrens C. Reverse shoulder arthroplasty for fracture sequelae: How the initial fracture treatment influences the outcomes of joint replacement. Acta Orthop Traumatol Turc. 2019;53(4):278-281. doi:10.1016/j.aott.2019.03.010
Ma GC, Bradley KE, Jansson H, Feeley BT, Zhang AL, Ma CB. Surgical Complications After Reverse Total Shoulder Arthroplasty and Total Shoulder Arthroplasty in the United States. J Am Acad Orthop Surg Glob Res Rev. 2021;5(7):21.00146. doi:10.5435/JAAOSGlobal-D-21-00146
Baek Md CH, Kim Md JG, Lee Md DH, Baek GR. Does Preservation of Coracoacromial Ligament Reduce the Acromial Stress Pathology Following Reverse Total Shoulder Arthroplasty? J Shoulder Elb Arthroplast. 2021;5:24715492211022171. doi:10.1177/24715492211022171
Kim SC, Kim IS, Jang MC, Yoo JC. Complications of reverse shoulder arthroplasty: a concise review. Clin Shoulder Elb. 2021;24(1):42-52. doi:10.5397/cise.2021.00066
Stull JD, Nicholson TA, Davis DE, Namdari S. Addition of 3% hydrogen peroxide to standard skin preparation reduces Cutibacterium acnes-positive culture rate in shoulder surgery: a prospective randomized controlled trial. J Shoulder Elbow Surg. 2020 Feb;29(2):212-216. doi: 10.1016/j.jse.2019.09.038.
Kaveeshwar S, Duvall G, Jones DL, O'Hara NN, Klein A, Diedrich AM, et al. Risk factors for increased shoulder Cutibacterium acnes burden. JSES Int. 2020;4(3):464-469. doi:10.1016/j.jseint.2020.04.020
Kircher J., Ohly B., Farkhondeh M., Magosch P., Mauch F. Analysis of revision shoulder arthroplasty in the German nationwide registry from 2014 to 2018. JSES Int. 2021 Feb 9;5(3):382-390. doi: 10.1016/j.jseint.2020.12.003.
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